Chronic pain afflicts an estimated 30 million to 50 million Americans, with social costs in disability and lost productivity adding up to more than $100 billion annually. Traditionally, pain was thought of as a symptom: treat the disease or ailment, pain will go away. Research now shows us this is true for ordinary or acute pain, which is a function of a healthy nervous system. Chronic pain, however, is continuous pain lasting longer than three to six months, or beyond the point of tissue healing. With chronic pain, it appears that pain can set up a pathway in the nervous system and become the problem in and of itself.

In chronic pain, the nervous system may be sending a pain signal even though there is no ongoing tissue damage. The nervous system itself misfires and creates the pain. In such cases, the pain is the disease rather than a symptom of an injury. Chronic pain produces abnormal changes in the brain and spinal cord. It unleashes a cascade of negative hormones like cortisol that adversely affect the immune system and kidney function. Far from being simply an unpleasant experience that people should endure with a stiff upper lip, chronic pain appears to have its own harmful effect on the body.

Chronic pain is influenced by many factors, such as ongoing pain signal input to the nervous system even without tissue damage, physical deconditioning due to lack of exercise, a person?s thoughts about the pain, as well as emotional states such as depression and anxiety. Chronic pain is much less well understood than acute pain.

Common Conditions of Chronic Pain

Chronic pain is not something to be ignored. Any condition of chronic pain should be discussed with a healthcare provider so that appropriate treatment can be found. Conditions of chronic pain include:

Arthritis: One of the most pervasive diseases in the United States and the leading cause of disability. In fact, most people over the age of 50 show some signs of arthritis as joints naturally degenerate over time. According to the Centers for Disease Control and Prevention one out of every three Americans (an estimated 70 million people) is affected by one of the more than 100 types of arthritis. Your doctor can tell if you have arthritis through blood tests and x-rays.

Fibromyalgia: A chronic pain illness characterized by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue and sleep disturbances with symptoms that fluctuate in intensity over time. Patients normally have up to 18 different tender points from which much of the pain imitates. The most common sites of pain include the neck, back, shoulders, pelvic girdle and hands, but any body part can be involved. It is estimated that 3-6% of the U.S. population has fibromyalgia. A higher percentage of women (of all ages and races) are affected, than men and children.

Neuropathic pain: Very different from pain caused by an underlying injury. Neuropathic pain feels different than musculoskeletal pain and is often described with the following terms: severe, sharp, lightning-like, stabbing, burning, cold, and/or ongoing numbness, tingling or weakness. While it is not completely understood, it is thought that injury to the sensory or motor nerves in the peripheral nervous system can potentially cause neuropathy.

Migraine: Affecting about 28 million Americans, a migraine is a recurring, throbbing headache that usually occurs on one side of your head. It is often accompanied by extreme sensitivity to light and sound, nausea, and vomiting. Migraine is three times more common in women than in men. In fact, many women suffer from menstrual migraines, which occur two days prior, during and up to three days after the menstrual period, and at no other time.

Other sources of chronic pain include temporomandibular joint diseases and disorders, commonly called TMJ, ongoing back and neck pain, and chronic muscle pain.

Treatment Options

Treatment options for chronic pain can include a combination of medication, exercise, rest, weight-management, nutrition and in some cases, surgery, but there is still much to learn about the safety and effectiveness of many chronic pain treatments.

Everyone should keep in mind that long-term use of many standard prescription and non-prescription pain relief medications can also have serious side effects. NSAID?s, such as aspirin, ibuprofen and COX-2 inhibitors are associated with damage to the stomach lining. Recent studies show that for arthritis, the nutritional supplements glucosamine and chondroitin may actually be as beneficial as NSAIDs without the side-effects. (For more information, click here.)

Acetaminophen, a key ingredient in many over-the-counter and prescription pain medicines such as Tylenol, helps many kinds of chronic pain, but too much acetaminophen could cause liver damage. Opioids like morphine are helpful for short-term pain relief but are highly addictive.

Compounded Medications Can Be Individualized

Specially compounded medications, customized for the individual's unique condition, offer many chronic pain patients the best hope for long-term pain relief. Specially compounded transdermal creams and gels can be applied directly to areas of pain and/or trigger points. Several pain medications can be combined in one topical gel to attack pain from many angles. Anti-inflammatories, muscle relaxants, steroids medications, and other medications can be combined for optimal results. Nutritional supplements can also be compounded to support pain relief.

Pain doesn't have to be a way of life. The pharmacists at Madison Pharmacy Associates are available to work with you and your healthcare provider to customize a prescription pain solution that is just right for you. Call us at 800.558.7046 for additional information. We are here to help.

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